Medicine:Cutis verticis gyrata
| Cutis verticis gyrata | |
|---|---|
| Other names | CVG |
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| Cutis verticis gyrata in a congenital imbecile | |
Cutis verticis gyrata is a medical condition usually associated with thickening of the scalp.[1] The condition is identified by excessive thickening of the soft tissues of the scalp and characterized by ridges and furrows, which give the scalp a cerebriform appearance. Clinically, the ridges are hard and cannot be flattened on applying pressure. Patients show visible folds, ridges or creases on the surface of the top of the scalp.[2] The number of folds can vary from two to roughly ten and they are typically soft and spongy. The condition typically affects the central and rear regions of the scalp, but sometimes can involve the entire scalp.
Hair loss can occur over time where the scalp thickens, though hair within any furrows remains normal. Thus far, due to the (apparent) rarity of the condition, limited research exists and causes are as yet undetermined. What is known, is that the condition is not exclusively congenital.
The condition was first reported by Jean-Louis-Marc Alibert in 1837,[3] who called it cutis sulcata.[4] A clinical description of the condition was provided by Robert[who?] in 1843[5] and it was named by Paul Gerson Unna in 1907.[6] It has also been called Robert-Unna syndrome, bulldog scalp, corrugated skin, cutis verticis plicata, and pachydermia verticis gyrata.[7]
Cause
At this time, causes are unknown, but it is believed to not be congenital.[citation needed]
Conditions and syndromes
CVG is a feature of several conditions:[8]
- Acromegaloid phenotype with cutis verticis gyrata and corneal leukoma
- Beare-Stevenson cutis gyrata syndrome
- Cutis verticis gyrata and intellectual disability
- Cutis verticis gyrata, thyroid aplasia, and intellectual disability
- Hypertrophic osteoarthropathy, primary, autosomal dominant
- NDE1-related microhydranencephaly
- Necrotizing encephalomyelopathy, subacute, of Leigh, adult
Diagnosis
There is no clinical diagnosis for CVG as cases are rarely seen and are often comorbid with other conditions.[citation needed]
Classifications
CVG is classified according to the presence, or lack of underlying cause. Studies suggest that CVG often occurs in individuals in a secondary form to other ailments. However, the condition can also be present on its own. CVG can be classified into two forms: ‘primary’ (essential and non-essential) and ‘secondary’.[9]
The classifications are:
- Primary essential
- Primary non-essential
- Secondary
Primary essential CVG is where the cause of the condition in unknown. It has no other associated abnormalities. This occurs mainly in men, with a male:female ratio of between 5:1 and 6:1, and develops during or soon after puberty. Because of the slow progression of the condition, which usually occurs without symptom, it often passes unnoticed in the early stage.[10]
Primary non-essential CVG can be associated with neuropsychiatric disorders including cerebral palsy, epilepsy, seizures, and ophthalmologic abnormalities, most commonly cataracts.[citation needed]
Secondary CVG occurs as a consequence of a number of diseases or drugs that produce changes in scalp structure. These include: acromegaly (excessive growth hormone levels due to pituitary gland tumours), and theoretically, the use of growth hormone itself or the use of drugs that mimic the effect of growth hormone (such as GHRP-6 and CJC-1295). It may also arise in association with melanocytic naevi (moles), birthmarks (including connective tissue naevi, fibromas and naevus lipomatosus), and inflammatory processes (e.g. eczema, psoriasis, Darier disease, folliculitis, impetigo, atopic dermatitis, acne).[citation needed]
Treatment
Options for medical treatment for this condition have been limited to plastic surgery with excision of the folds by means of scalp reduction/surgical resection. Scalp subcision has also been suggested as a treatment.[11] Additional suggestions also include injections of a dermal filler (e.g. (poly-L-lactic acid)).[12]
Two published medical journals appear to show Hyaluronidase injections (Hyaluronidase is an enzyme used to dissolve hyaluronic acid which is a component of our skin that contributes to its thickness) as a possible treatment.[13][14]
See also
- Skin lesion
- List of cutaneous conditions
References
Notes
- ↑ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology (10th ed.). Saunders. p. 572. ISBN 978-0-7216-2921-6. https://archive.org/details/andrewsdiseasess00mdwi_659.
- ↑ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. p. 1502. ISBN 978-1-4160-2999-1.
- ↑ "Primary essential cutis verticis gyrata in an adult female patient: a case report". The Journal of Dermatology 33 (7): 492–5. July 2006. doi:10.1111/j.1346-8138.2006.00116.x. PMID 16848824.
- ↑ Georgescu, Simona Roxana; Sârbu, Maria Isabela; Mitran, Cristina Iulia; Mitran, Mădălina Irina; Rusu, Alice; Benea, Vasile; Tampa, Mircea (2016). "Cutis verticis gyrata in a patient with multiple basal cell carcinomas; case presentation and review of the literature". Journal of Mind and Medical Sciences 3 (1): 80–87. https://scholar.valpo.edu/jmms/vol3/iss1/10.
- ↑ Skibinska, Malgorzata D.; Janniger, Camila K. (February 2019). "Cutis Verticis Gyrata". Medscape. http://emedicine.medscape.com/article/1113735-overview.
- ↑ Unna, PG (1907). "Cutis verticis gyrata" (in de). Monatshefte für praktische Dermatologie 45 (5): 227–33. OCLC 815639790. https://babel.hathitrust.org/cgi/pt?id=mdp.39015046999390&view=1up&seq=275.
- ↑ Levine, Norman (2004). Dermatology Therapy A-Z Essentials. Berlin New York: Springer. p. 166. ISBN 978-3-540-00864-4.
- ↑ "Cutis gyrata of scalp (Concept Id: C0263417)" (in en). https://www.ncbi.nlm.nih.gov/medgen/78095.
- ↑ Radwanski, Henrique N.; Rocha Almeida, Marcelo Wilson; Pitanguy, Ivo (2009). "Primary essential cutis verticis gyrata – a case report". Journal of Plastic, Reconstructive & Aesthetic Surgery 62 (11): e430–e433. doi:10.1016/j.bjps.2008.06.062. ISSN 1748-6815. PMID 18951076.
- ↑ "MRI in essential primary cutis verticis gyrata". Neuroradiology 43 (10): 841–4. October 2001. doi:10.1007/s002340100591. PMID 11688700.
- ↑ "Using novel subcision technique for the treatment of primary essential cutis verticis gyrata". International Journal of Dermatology 48 (3): 307–9. March 2009. doi:10.1111/j.1365-4632.2009.03927.x. PMID 19261024.
- ↑ "Unusual and rare complication described in San Francisco | CATIE – Canada's source for HIV and hepatitis C information". http://www.catie.ca/en/catienews/2013-12-05/unusual-and-rare-complication-described-san-francisco.
- ↑ Chaghouri, Patrick; Elahi, Maria H.; Elahi, Mohammed M. (2021). "Hyaloronidase as a Treatment for Cutis Verticis Gyrata". Plastic Surgery Case Studies 7: 2513826X2110222. doi:10.1177/2513826X211022221.
- ↑ Welborn, Macartney; Dallo, Christopher; Altmeyer, Mary (5 January 2019). "Cutis Verticis Gyrata Improved with Injected Hyaluronidase Treatments". Dermatology Archives 3 (1). doi:10.36959/661/304. https://scholars.direct/Articles/dermatology/dma-3-018.php?jid=dermatology.
Bibliography
- Nguyen NQ (October 2003). "Cutis verticis gyrata". Dermatology Online Journal 9 (4): 32. doi:10.5070/D31DP6W6KS. PMID 14594605. http://dermatology.cdlib.org/94/NYU/Nov2002/9.html.
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